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General NPI Number Information
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NPI Number | 1164102844
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Entity Type | Individual
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Provider Name | GRETCHEN VENEZIA ARNOLD RDH
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Gender | Female
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Dates
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Enumeration Date | 07/19/2023
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Last Update Date | 07/19/2023
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Provider Practice Location Address
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Address Line | 763 BURNSIDE AVE
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City | EAST HARTFORD
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State | CT
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Zip | 06108-2791
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Country | US
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Telephone | 860-291-9154
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Fax | 860-291-9728
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Provider Business Mailing Address
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Address Line | 47 RIMFIELD DR
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City | SOUTH WINDSOR
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State | CT
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Zip | 06074-1854
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Country | US
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Telephone | 860-836-8796
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 005378
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License Number State | CT
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